What Causes Baby Eczema—and How to Treat It
Is there anything yummier than a baby’s soft, smooth skin? Though babies are known for exactly that, picture-perfect skin isn’t always the case, and baby eczema is often to blame. Babies have extra-sensitive skin, so they’re more prone to rashes than older kids or adults. Luckily, there are baby eczema treatments that will soon get baby comfy in his own skin.
Baby eczema (or atopic dermatitis) appears as red or dry patches of skin, and it’s usually also itchy and rough. For babies who are predisposed to eczema, the first rashes typically appear around 2 to 4 months of age. “Baby eczema often starts as a pink, flaky rash on the cheeks and chin in young babies,” says Anna Bender, MD, a pediatric dermatologist at Weill Cornell Medicine and New York-Presbyterian in New York City. “Older babies who are of crawling age may develop the rash more on the outside of their arms and legs with dry, itchy, irritated skin patches. It may also feel rough to the touch like sandpaper.”
It can be easy to confuse baby eczema vs acne—both can appear on the cheeks. But baby acne essentially consists of small pimples, while baby eczema is also flaky and simply looks very itchy and irritated. Babies might rub their face with their hands. They might rub their legs and feet or hands together, or they may rub their face on their parents’ clothes. In addition, eczema in babies can be divided into three categories:
- Mild baby eczema: dry skin patches and can be treated with moisturizers alone.
- Moderate baby eczema: pinker dry and flaky patches that may need a cortisone cream or ointment (see “Baby Eczema Treatment,” below).
- Severe baby eczema: the reddest and flakiest of all three varieties; occurs on a larger surface area of the body and is usually harder to control with over-the-counter products. May also be infected, with scabbing and oozing in some spots.
Baby eczema is thought to be caused by a combination of (or, more specifically, an interplay of) genetic and environmental factors. “It occurs in families with a history of eczema, asthma and seasonal allergies,” explains Bender. “The immune system of people with eczema is more allergically prone.” What’s more, she says, the skin lacks a strong barrier to the outside world, so it can become easily irritated and dry. As a result, these babies are especially sensitive to certain factors that will incite a breakout. Different babies may be particularly vulnerable to different agents. A few common triggers of eczema in babies include:
- Dry skin (which is why eczema can be common in winter)
- Irritants (such as soaps, household detergents, wool, polyester)
- Heat and sweating
- Allergens (pet dander, pollen, dust)
- Saliva (from drooling)
Is Eczema Common in Babies
The short answer is yes. Up to 20 percent of children in the United States may have some form of eczema, according to Bender.
Mild baby eczema may need nothing more than an over-the-counter moisturizer, but more severe cases may require treatment from your pediatrician. Whatever the case may be, always check in with your pediatrician if baby breaks out. Depending on severity, your doctor may suggest some or all of these baby eczema treatment options:
- A gentle moisturizer is your first line of defense for baby eczema. “My son has [eczema] on his face and legs,” says one mom. “I use Aquaphor ointment on the patches for the flare-ups. Once that clears, we use regular Eucerin lotion after every bath, and his flare-ups have been really minimal.” Apply it all over your baby’s body to soothe rough spots and also to improve the barrier function.
- Proper daily skin care is crucial for keeping baby’s eczema-prone skin hydrated. Limit bath time to 15 minutes and use warm—not hot—water. Choose gentle cleansers without fragrance, and avoid harsh soaps. After the bath, pat—don’t rub—your baby’s skin dry within three minutes of taking him out of the water. Finally, apply moisturizer to his whole body.
- If the problem doesn’t go away, your pediatrician may suggest a prescription for a low-to-medium-strength topical steroid ointment or cream, which can be used once to twice daily to help the inflammation and heal the skin. If you’re prescribed creams or ointments, it’s important to follow up with a doctor as directed to make sure it’s working properly. One mom we spoke to was given a cream that she applied four times a day on her daughter Grace, who had dry, bumpy skin all over her arms, legs, belly and back. “It went away. Then it came back about three weeks after I stopped using the cream, but not nearly as bad as the first time,” she says. “I applied the cream a few more times, and it hasn’t been back since. It’s been about three weeks now.”
- Inflamed skin is also more prone to infection. Your pediatrician may also suggest very diluted bleach baths for more-severe baby eczema or eczema-associated skin infections. Add 1⁄4 cup of Clorox bleach to a half-full tub of water, or 1 tablespoon of Clorox in a full baby tub of water, twice a week for bath time to decrease bacteria on the skin and prevent infection.
Baby Eczema Natural Remedies
Since babies have extra-sensitive skin, it’s natural to want to treat it, well, naturally. But, Bender says, “even natural products have the potential to cause a worsened rash called contact dermatitis, so check with your doctor first before applying something new to your baby’s skin. Also, use only a small amount of any new product first and stick to gentle products with simple ingredient lists.” Here are a few natural baby eczema remedies that are safe for baby:
- Coconut oil is a natural moisturizer.
- A home remedy for baby eczema is “wet wrap therapy” (also called wet pajama therapy): Bathe your baby and then apply a thick moisturizer to the slightly damp skin. Dampen a pair of cotton pajamas in warm water, wring them out and slip them on baby, right over the thick layer of moisturizer. After that, put on a second dry pair of cotton pajamas. Keep baby wrapped like this for a few hours or longer.
Updated October 2017